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South Carolina rates for HCPCS B4164

Parenteral Nutrition Solution: Carbohydrates (Dextrose) 50% Or Less (500 Ml = 1 Unit) - Homemix (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130 4450)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.47 / $23.47 / $23.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.04 / $21.59 / $23.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.66 / $24.66 / $30.83
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.12 / $23.47 / $36.90
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.78 / $9.78 / $9.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.52 / $19.46 / $25.02